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RR (12-1111)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12-00001111 Property Address: 56893 MERION APN: 762 -031 -001 - Application description: RE -ROOF Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 1500 T,iht 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: PGA WEST RES 39755 BERKEY PALM DESERT, II STE. A CA 92260 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and -my License is in full force and effect. License Class: C39 n A n License N6*'.,/77A482 , OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500).: (_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_) I am exempt under Sec. , BAP.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: �( Lender's Address: 1 LQPERMIT VOICE (760 FAX (76 1 INSPECTIONS (760) - Date: 9/24/12 OCT 0 201 CITY OF LA QUINTA FINANCE DEPT. WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier STATE FUND Policy Number 1890178-2011 _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so s to b ome subject to the workers' compensation laws of California, and agree that, if I shou eco a subject tX workers' c enation provisions of Section 3700 of the Labor Cod I sh forthwith cy with th a ovisionS. �44licant: �ZJ WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or fallowing issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to buildi 1 nstruction, and hereb thorize representatives of�thi oounty to nter upon the above-mentioned propert fr nspecti purposes. % ` _��ignature (Applicant or Agent): Contractor: Applicant: Architect or Engineer: WILLIAMS ROOFING P.O. BOX 391841 ANZA, CA 92539 (760)399-9394 1 IQ LiC. No.: 774482 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and -my License is in full force and effect. License Class: C39 n A n License N6*'.,/77A482 , OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500).: (_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_) I am exempt under Sec. , BAP.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: �( Lender's Address: 1 LQPERMIT VOICE (760 FAX (76 1 INSPECTIONS (760) - Date: 9/24/12 OCT 0 201 CITY OF LA QUINTA FINANCE DEPT. WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier STATE FUND Policy Number 1890178-2011 _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so s to b ome subject to the workers' compensation laws of California, and agree that, if I shou eco a subject tX workers' c enation provisions of Section 3700 of the Labor Cod I sh forthwith cy with th a ovisionS. �44licant: �ZJ WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or fallowing issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to buildi 1 nstruction, and hereb thorize representatives of�thi oounty to nter upon the above-mentioned propert fr nspecti purposes. % ` _��ignature (Applicant or Agent): r 1. LQPERMIT Application Number . . . . Permit . . . RE -ROOF Additional desc . . Permit Fee . . . . 30.00 Issue Date . . . . Expiration Date . . 3/23/13 12-00001111 Plan Check Fee . . .00 Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 30.00 ---------------------------------------------------------------------------- Special Notes and Comments RE -ROOF REAR PATIO FLAT DECK WITH URETHANE FOAM ROOF SYSTEM. 2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary ----------------- Charged Paid -------------------- Credited -------------------- Due Permit Fee Total 30.00 .00 .00 30.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 31.00 .00 .00 31.00 1 P.O. Box 391841, Anza, Ca. 92539 951-763-0769 5o-855 Washington St 2c, # 130, La Quinta, Ca 92.2-53 760-399-9394 Contract #5038 For: Monarch Management Trust, 39-755 Berkey Suite A, Palm Desert, Ca. 92260 Attn: JoAnne Rose Date: July 15, 2012 job Addresses: 56-893 Merion, La Quinta, Ca. 92253 Schedule of extras if aoolicable: During the repair process, if any asbestos is discovered, the removal and disposal cost would be borne by owner. Any dry rot will be replaced for an additional charge based on $81.00 per hour labor and ix6 or 1x8 materials at $ 2.50 per foot. Any damaged rafter ends will be replaced for an additional charge based on s iog.00 each and fascia board at $12.00 per lin. Ft. Any CDX/OSB plywood to be replaced at an additional charge based on $ 2.00 per sq. foot, labor included. Scope of Work as follows; Urethane foam roof system as follows on the above rear patio flat deck only: Clean and prep roof decks to accept new materials. Install new edge metals as needed. Wipe down and prime edge metals. Install "' 3.0 SPF Poly Urethane foam roof system as per manufactures specifications. Install Acrylic roof coating as per manufactures specifications @ a rate of 12" on perimeter and to receive 4 gallons per every loo square feet. Remainder of roof system to receive 3 gallons per every loo square feet as per manufactures specifications. (This roof system is Title 24 Compliant) Contract Price: $ 1,500.00 Payment to be made as follows: To be paid upon regular billing cycle. (As completed) Williams Roofing to leave jobsite clean and free of debris. **Ten year workmanship warranty on all work performed by Williams Roofing only** Owner/Agent Contractor Prescriptive Certificate of Compliance: Residential Reroof CF-iR-ALT-ReRoc Project Address: 569g3 Mepj()� Climate Zone Permit N ROOFING PRODUCTS (COOL ROOFS) §151(012 When the area of exterior root surface to be replaced exceeds 50% of the exist/ng roof area, or 1, 000 fe, whichever Is less, the nei rooting area must meet the rooting product "Cool Roof" requirements of §152(b)1H1, 152(b)MY, or 152(b)MIN, Check applicable alternative or exception below if the roof alteration Is exempt from the roofing product "Cool Roor requirements:: ❑ Cool roofs M required In Climates Zones 1-12,14, and 16 with a low sloped roof pitch (less or 2:12 pitch). ❑ Cod roofs PQt required In Climates Zones 1-9, and 16 with a steep -sloped roofs (greater pitch than 2:12) and product weightless than 50/1 Alternatives to §152(b)1HI and 1152(b)Hll, Steep -slope roof (pitch> 2:12) ❑ Insulation with a thermal resistance of at least 0.85 heft-OF/Btu or at least a 314 Inch air -space is added to the roof deck over an aft, or ❑ Existing ducts in the attic are insulated and sealed according to §151(})10; or ❑ In climate zones 10, 12 and 13, with 1112 of free ventilation area of attic ventilation for every 150 tt2 of attic: floor area, and where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the root ridge; or ❑ Building has at least R-30 ceiling insulation; or ❑ Building has radiant barrier in the attic meeting the requirements of §151(92; or ❑ Building has no ducts in the attic; or ❑ In climate zones 10, 11, 13 and 14, R-3 or greater roof deck insulation above vented attic. Exception to §152(b)1 Hill, Low -slope roof ( pitch s 2.12) ❑ Building has no ducts In the attic. Other Exceptions ❑ Roofing area is covered by building integrated; photovoltaic panels and solar thermal panels are exempt from the Cod Roof criteria. ❑ Root constructions that have thermal mase over the roof membrane with at least 25 Ib/ft2 are exempt from the Cod Roof criteria. NOTE: If any one of the alternatives or exception is checked the Aged Solar Reflectance and Thermal Emittance requirements for roofing products in § 118(1) are not applicable. Do not fill table below. NOTE: When a Coot Root is required, the installing contractor shall complete and submit the CF -BR -ENV -01 for final inspection. Declaration Statement Roof Slope Product Weight Product Aged Solar Thermal Campsft], CRRC Product ID Number s 2:12 > 2:12 < 51bife a 516/fe TypW Reflectance A Emitta ce SRIS ❑ ❑ ❑ ❑° .�(3 ❑ ❑ ❑ ❑ ❑4 Note: If no CRRC- t label Is available, this compliance method cannot be used, use the Performance Approach to show compliance, 1. The CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rat Product Directory at www.coolrools.oryoroducts/search.vho 2. Indicate the type of product is being used for the roof top, i.e. single -ply root, asphalt roof, metal roof, etc. 3. If the Aged Reflectance is not available in the Cool Roof Rating Council's Rated Product Directory then use the Initial Reflectance value from the same directory and use the equation (0.2+0.7ip„ w - 0.2) to obtain a calculated aged value. Where pia the Initial Solar Reflectance. 4. Check box if the Aged Reflectance is a calculated value using the equation above. 5. Calculate the SRI value by using the SRi- Worksheet at httnl/www.ene .ca.and enter the resulting value in the SRI Column above and attach acopy of the SRI- Worksheet to the CF -1 R. To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coven recommended by the coatings manufacturer and most minimum performance requirements listed in §118(1)4. Select the applicable coating: ❑ Aluminum -Pigmented Asphalt Roof Coating ❑ Cement -Based Roof Coating ❑ Other NOTE: When a Coot Root is required, the installing contractor shall complete and submit the CF -BR -ENV -01 for final inspection. Declaration Statement • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is.accurate and complete. • t certify that the energy features and performance specificatlons identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and 8 of the California Code of Regulations. Name:2e A-] hm I Signature: oovel� Campsft], p kci Addr License: C1tyiftzlq. Phone11A0 _16_M For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300. Permit # Je Project Address: A.P. Number: Legal Descriitin M Submittal Plan Sets Structural Calcs. Truss Calcs. Title 24 Cales. Flood plain plan Grading plan Subcontactor List Grant Deed H.O.A. Approval IN HOUSE: - Planning Approval Pub. Wks. Appr School Fees City Of La Quinta Building 8t Safety Division P.O. Box 1504, 78-49S Calle Tampico La Quinta, CA 92253 - (760) 777.7012 Building Permit Application and Tracking Sheet iy IV tuner's Name: nI J♦rie' i . ST, Zip: � ' � ►u� � phone: I:--!!5! :ct Description: _ T_ Citv Lic. #: Construction Type: Occupanc} Project type (circle one)IA III it: New Add'n Alter Repair Demo SSq. Ft.: it Stories: #Units: t t r erl r t r-' —I t/ r Estimated Value of Projec APPLICANT: DO NOT WRITE BELOW THIS LINE 'd Recd TRACKING Plan Check submitted Reviewed, ready for corrections Called Contact Person Plans picked up Plans resubmitted 2" Review, ready for corrections/issue Called Contact Person Plans picked up Plans resubmitted RevieN, ready for corrections/issue Called Contact Person Date of permit issue PERMIT FEES Item Plan Check Deposit Plan Check Balance Construction Mechanical Electrical Plumbing S..M.I. Grading Developer Impact Fee A.I.P.P. Total Permit Fees Amount : 4f ip: MStat 13� ..1 jCQ Ll ., Designer: Address: City, ST, Zip: Tcicphonc: State Lic. #: Name of Contact Person: Telephone # of Contact Person: M Submittal Plan Sets Structural Calcs. Truss Calcs. Title 24 Cales. Flood plain plan Grading plan Subcontactor List Grant Deed H.O.A. Approval IN HOUSE: - Planning Approval Pub. Wks. Appr School Fees City Of La Quinta Building 8t Safety Division P.O. Box 1504, 78-49S Calle Tampico La Quinta, CA 92253 - (760) 777.7012 Building Permit Application and Tracking Sheet iy IV tuner's Name: nI J♦rie' i . ST, Zip: � ' � ►u� � phone: I:--!!5! :ct Description: _ T_ Citv Lic. #: Construction Type: Occupanc} Project type (circle one)IA III it: New Add'n Alter Repair Demo SSq. Ft.: it Stories: #Units: t t r erl r t r-' —I t/ r Estimated Value of Projec APPLICANT: DO NOT WRITE BELOW THIS LINE 'd Recd TRACKING Plan Check submitted Reviewed, ready for corrections Called Contact Person Plans picked up Plans resubmitted 2" Review, ready for corrections/issue Called Contact Person Plans picked up Plans resubmitted RevieN, ready for corrections/issue Called Contact Person Date of permit issue PERMIT FEES Item Plan Check Deposit Plan Check Balance Construction Mechanical Electrical Plumbing S..M.I. Grading Developer Impact Fee A.I.P.P. Total Permit Fees Amount Building 56^893 Herion. Address Owner X51, PGA. Weat T, &-t 4 4 Q" P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Mailing Address 7--$1v4. 54 City Zip Tel. La Quints, CA 92.253 564-4463 Owner/Builder kddress i ty State Lic. I City & Classif. Lic. # Arch., Engr., Designer Address Tel. City IZip I State I Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to rile a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a civil penalty of not more than rive hundred dollars ($500). O I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or Improve for the purpose of sale.) O I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) peened pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this�ttreason � A aate* �Lr Owner h fl t s WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Crppensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) PoLy No.// Company W_rCopy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thg work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above-. mentioned property for Inspection purposes. Signature of applicant— Date Mailing Address City, State, Zip No. 15235 BUILDING: TYPE CONST. OCC. GRP. A.P. Number Legal Description Project Description Pedestal for fans on Nicholas Privates Course the Sq. Ft. Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $500.00 m PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical .i.3. Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL • REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from R a5 , Line Side Street Setba�c�k�JUoom Center` Line Side Setback fir/ roperrty Line FINAL DATE !&SPECTOR'- ,C' Issued by: Dat `� Permit / Validated by: � \ t9T Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINU FEES IST FL. SO. FT. ® $ 2ND FL. SO. FT. POR. SO. FT. ® GAR. SO. FT. ® CAR P. S0. FT. WALL SO. FT. SO. FT. ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEOUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. ®c BATH TUB AL INSP SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1'A c SEWAGE DISPOSAL SO.FT.GAR ® 3/ec HOUSE SEWER VENTILATION GAS PIPING PERMIT FEE FIRE ZONE ROOFING ' PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. AL INSP FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING ' FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCG FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL T a 0 Wy� 4 4 a" Building Address 56'-f393 Mfif�tan Owner Sunrise Compal Address 42-600 Conk Street Suite 200 P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 City Zip Tel. Pala Desert 92260 1 566-28.28 Contractor Mraltfonal Mortgage & Land Same ty State Lic. I City & Classif. 288130 Lic. # 396 Arch., Engr., Designer Address Tel. CityI Zip I State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License law for the following reason: (Sec. 7031.5,Busnass and Professions Code: Any city or county which requires a permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to Ne a signed statement that he is licensed pursuant to the provisions of the Contractors License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars (E500). O I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who bull. or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not buNd or improve for the purpose of sale.) O I, as owner of the properly, am exclusively contracting with licensed contractors to corF struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No Company ❑ Copy is filed with the city. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE .(This section need not be completed ff the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thg work for which this permit is issued, I shall not employ any pperson in any manner so as to become subject to the Workers' Compensation Laws of Califomia Date Owner NOTICE TO APPLICANT., ff, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such Provisions Or this permit shag be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lenders Name Lenders Address This is a building permit when property filled out signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I car ity that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above-- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, zip Jz No. 07243 S1-� BUILDING: TYPE CONST. OCC: GRP. A.P. Number PG Legal Description Tract 24801 Project Description Phase 5H " Plan N3$ Sq. Ft. 2899 Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $214,923 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal.. Const. 1,0 Mech... Electrical U2.71 Plumbing 1W.5— S.M.I. Grading Driveway Enc. Infrastructure 4,635. 77 e b crudit 21417.89 ltiTra Due ~• TOTAL r * / ! r l REMARKS {k.! c.:,(t ,'i �.r� t _!)�� cmt�.r,•. t!f ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date 212$190 Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS A.C. UNIT COLL. AREA SLAB GRADE YARD SPKLR SYSTEM 2ND FL. SO. FT. BONDING HEATING (ROUGH) MOBILEHOME SVC. BAR SINK POR. Sp. FT. ® EWER OR SEPT C4e4 6 ROUGH WIRING. GAR. SO. FT. ® IPOWER OUTLET ROOF DRAINS FOUND. REINF.3. 90 C• DRAINAGE PIPING CAR P. SO. FT. ® HEATING (FINAL) WALL SQ. FT. REINF. STEEL DRINKING FOUNTAIN. SO. FT. ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation WATER HEATER FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER $ GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LUMBER GR. LAUNDRYTRAY AIR HANDLING UNIT CFM FINAL INSP. KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE,TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SQ. FT. ®c 1BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1% c SEWAGE DISPOSAL SPARK ARRESTOR SQ.FT.GAR ® V4c HOUSE SEWER GAR. FIREWALL GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS EWER OR SEPT C4e4 6 ROUGH WIRING. DUCT WORK ROCK STORAGE FOUND. REINF.3. 90 C• ��aAS (ROUGH){ �� 'y� O W METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM $ GRADING cu. yd. plus x$ =$ LUMBER GR. INAL INSPI%Q l — FRAMING �� FINAL INSP. ROOFING —�. REMARKS: VENTILATION FIRE ZONE ROOFING: FIREPLACE SPARK ARRESTOR GAR. FIREWALL V4ATHING Zy MESH VNSULATIONISOUND-1// vv FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESlINITIALS GARDEN WALL FINAL